Registered Nurse - OR Circulator

Veterans Affairs, Veterans Health Administration | Pittsburgh, PA

Posted Date 6/30/2020
Description This position is accountable to the Operating Room Nurse Manager and will be located at the University Drive campus of the Pittsburgh VA Medical Center. The OR specializes in caring for adult and geriatric Veterans during the perioperative experience and provides the following services: General Surgery, Ear, Nose & Throat, Ophthalmic, Peripheral Vascular, Thoracic, Urologic, Plastic, Podiatric, Endoscopic and Laparoscopic, Cardiac Open Heart, Neurosurgery, Transplant, and Major Orthopedic.

A perioperative nurse at the Pittsburgh VA Medical Center is accountable for patient outcomes resulting from the nursing care provided during the perioperative experience. A perioperative nurse functioning in a circulating role must plan and direct the nursing care of every patient undergoing surgical and/or other invasive procedures, thus requiring a 1:1 perioperative nurse to patient ratio. The incumbent must possess the technical and operational knowledge and clinical skills to function as a circulating and scrub nurse, and demonstrate a variety of specialized diagnostic and treatment procedures. S/he must demonstrate and maintain competencies required for all processes, procedures and equipment used in the operating room. The preferred candidate will either hold, or work towards acquiring, a Certified Nurse Operating Room (CNOR) certification. As part of the scope of clinical responsibilities, the selected candidate will:
  1. Demonstrate expertise, in both the circulating and scrub nurse roles, in a minimum of one surgical specialty and demonstrate minimal competency in all other surgical specialties aforementioned as being performed at the Pittsburgh VA Medical Center.
  2. Demonstrate competency in the pre-operative assessment of surgical patients:
    • This includes functioning as the patient's advocate in regard to assessing the patients understanding of the surgical consent and procedure they are about to undergo.
    • Assessing that the patient has followed pre-operative instructions, i.e. NPO status, halting of anti-coagulation medication, etc.
    • Maintaining accountability for promoting patient safety, continuity and quality of care, and the general well-being of the patient.
  3. Ensure all instruments, supplies and equipment are present and functional before the surgical procedure; ensure sterility of all the surgical instruments before the surgical procedure.
  4. Ensure counting of surgical instruments and specialty equipment occurs prior to and at the end of the procedure to ensure all instruments are accounted for prior to patient leaving the surgical suite.
  5. Perform proper surgical time-out prior to incision, and when pertinent, perform a fire safety time-out prior to the start of a surgical procedure.
  6. Maintain accountability for completing all Operative Documentation, i.e. Vista intra-operative record, DSS Live Data Time Surgical Time Out and safety checks; ensure the proper documentation and accountability of surgical specimens.
  7. Ensure post-operative pre-cleaning of instruments and transport to Sterile Processing.
  8. Protect the sterile field by monitoring for breaches in sterile technique during the procedure.
  9. Maintain order and cleanliness in the Operating Room at all times and limit traffic in and around the surgical field.
  10. Assist the surgeons during surgery, coordinate with surgical technicians, collaborate with physicians and ancillary services as necessary.
  11. When assigned, demonstrate competency in the scrub role, quickly handing over instruments or equipment to the surgeon during the surgery.
  12. Strive to maintain clinical competencies through continuous study, in services and participation in obtaining continuing education units. Based on education and experience, may be assigned responsibilities as preceptor or mentor.
This is a Bargaining Unit position.
Work Schedule: Rotating day/evening, day/night, weekends, and periods of on-call.
Financial Disclosure Report: Not required
Applicants pending the completion of educational or certification/licensure requirements may be referred and tentatively selected but may not be hired until all requirements are met.

Basic Requirements:
  • United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy.
  • Graduate of a school of professional nursing approved by the appropriate State-accrediting agency and accredited by one of the following accrediting bodies at the time the program was completed by the applicant: The Accreditation Commission for Education in Nursing (ACEN) or The Commission on Collegiate Nursing Education (CCNE). In cases of graduates of foreign schools of professional nursing, possession of current, full, active and unrestricted registration will meet the requirement of graduation from an approved school of professional nursing. OR The completion of coursework equivalent to a nursing degree in a MSN Bridge Program that qualifies for professional nursing registration constitutes the completion of an approved course of study of professional nursing. Students should submit the certificate of professional nursing to sit for the NCLEX to the VA along with a copy of the MSN transcript. (Reference VA Handbook 5005, Appendix G6) OR In cases of graduates of foreign schools of professional nursing, possession of a current, full, active and unrestricted registration will meet the requirement for graduation from an approved school of professional nursing.
  • Current, full, active, and unrestricted registration as a graduate professional nurse in a State, Territory or Commonwealth (i.e., Puerto Rico) of the United States, or the District of Columbia.
Preferred Experience: MSN or Certified Nurse Operating Room (CNOR) Certification; Five (5) years of Operating Room experience at a Level One facility (i.e. Open Heart, Transplant, Total Joints, etc.); Scrub experience.

Grade Determinations: The following criteria must be met in determining the grade assignment of candidates, and if appropriate, the level within a grade:
  • Nurse I Level I - An Associate Degree (ADN) or Diploma in Nursing, with no additional nursing practice/experience required.
  • Nurse I Level II - An ADN or Diploma in Nursing and approximately 1 year of nursing practice/experience; OR an ADN or Diploma in Nursing and a bachelor's degree in a related field with no additional nursing practice/experience; OR a Bachelor's of Science in Nursing (BSN) with no additional nursing practice/experience.
  • Nurse I Level III - An ADN or Diploma in Nursing and approximately 2-3 years of nursing practice/experience; OR an ADN or Diploma in Nursing and a Bachelor's degree in a related field and approximately 1-2 years of nursing practice/experience; OR a BSN with approximately 1-2 years of nursing practice/experience; OR a Master's degree in nursing (MSN) or related field with a BSN and no additional nursing practice/experience.
  • Nurse II - A BSN with approximately 2-3 years of nursing practice/experience; OR ADN or Diploma in Nursing and a Bachelor's degree in a related field and approximately 2-3 year's of nursing practice/experience; OR a Master's degree in nursing or related field with a BSN and approximately 1-2 year's of nursing practice/experience; OR a Doctoral degree in nursing or meets basic requirements for appointment and has doctoral degree in a related field with no additional nursing practice/experience required.
  • Nurse III - Master's degree in nursing or related field with BSN and approximately 2-3 year's of nursing practice/experience; OR a Doctoral degree and approximately 2-3 year's of nursing practice/experience.
Reference: VA Regulations, specifically VA Handbook 5005, Part II, Appendix G-6 Nurse Qualification Standard. This can be found in the local Human Resources Office.

Physical Requirements: Heavy lifting (35 pounds); heavy carrying (35 pounds); straight pulling (2-4 hours); pushing (2-4 hours); reaching above shoulders (1-2 hours); use of fingers; both hands required; walking (4-6 hours); standing (4-6 hours); repeated bending (2-4 hours); both legs required; ability for rapid mental and muscular coordination simultaneously; near vision correctable at 13" to 16" to Jaeger 1 to 4; far vision correctable in one eye to 20/20 and 20/40 in the other; both eyes required; ability to distinguish basic colors and shades of color; hear (aid permitted); mental and emotional stability.

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